Racial Disparity in Hypertension Control

Tallying the Death Toll

More than 7,600 African Americans die from strokes and heart disease each year because their blood pressure is not as well controlled as that of White Americans, according to this study which analyzed racial disparity in hypertension control.

Previous studies have shown hypertension, a precursor to cardiovascular disease, is more prevalent and not as well controlled in African Americans, versus Whites. But this is the first study to attempt to quantify annual heart disease and stroke deaths that would be avoided or postponed if the hypertension of African Americans was controlled as well as that of White Americans. The findings are based on national survey data of 1,545 African-American adults and 1,335 White adults.

Key Findings:

African-American men and women with hypertension have higher mean systolic blood pressure than their White counterparts, 6.5 mm Hg higher for African-American men and 8.2 mm Hg higher for African-American women.

Eliminating this racial disparity would reduce annual African-American deaths from heart disease and stroke by an estimated 5,480 and 2,190, respectively.

Racial parity in hypertension control also would reduce annual mortality rates from heart disease and stroke among African-American men by 17 percent and 16 percent, respectively, and among African-American women by 9 percent and 14 percent, respectively.

Previous studies reveal little evidence of difference in diagnosis and treatment between the two racial groups; African Americans do not have more severe hypertension than Whites and do not respond less favorably to drug treatment. But there is evidence of racial disparity in adherence to medication treatment plans. This difference has been reduced in programs designed to address the reasons why people do not take their medication as prescribed, such as medication costs, personal beliefs, anticipated adverse effects and health literacy.

The authors conclude better hypertension control among African Americans is likely an attainable goal, if sufficient resources are available to discover and address barriers to treatment adherence. Noting limitations of their data, they call for more research, especially regarding gender differences and the underlying reasons for the disparities that lead to so many more African-American deaths.